钛杆式人工髁状突在颞颌关节重建中的应用研究

目的：探讨纯钛杆式人工髁状突在颞颌关节重建中的临床应用效果。材料与方法：应用纯钛加工成杆式人工髁状突，关节头呈球面状，直径8mm，相连的柄厚1.5mm,宽5mm，长有25mm、30mm、35mm、40mm、60mm、80mm、100mm、120mm短的为直杆型，长的为角型，柄上有3-6个孔，孔径为2mm。纯钛螺钉直径1.5mm，长有5mm、7mm、9mm、10mm，用以固定钛人工髁状突。截除髁状突或下颌升支后，根据关节凹的位置，在下颌升支或下颌体表面用骨凿凿出与钛人工髁状突柄相适应的凹槽，再用螺钉固定钛人工髁状突于下颌升支或下颌体上，术后颌间固定2周。结论：从2000年1月至2002年4月，笔者应用纯钛加工成简易钛杆式人工髁状突，应用于临床10例，其中4例颞颌关节强直、4例成釉细胞瘤、2例角化囊肿，取得了较好的临床应用效果。结论：简易杆式钛人工髁状突具有良好的生物相容性，手术简单，固定牢固，人工髁状突呈球面状，利于各个方向的运动，适宜于不同患者髁状突及升支部缺损颞颌关节重建，术后能立即恢复患者面容、咀嚼与语言功能，具有重要的临床应用价值。

APPLICATION STUDY ON ARTIFICIAL BAR TITANIUM CONDYLE PROSTHESIS FOR RECONSTRUCTION OF TEMPORO- MANDIBULAR JOINT

Objective:To study the effect of clinical appli cation on artificial bar titanium co ndyle prosthesis for reconstruction of te mporo -mandibular joint.Methods:Artificial titanium condyle pros-thesis were made with pure titanium.The head of artificial bar titanium c indyle prosthesis was sphere shape.Diameter was 8mm.The stem thi ck was 1.5mm and wide 5mm,The length was variety:25mm,30mm,35mm,40mm,60mm,80mm,100mm,120mm.There were three to six poles i n the bar.Pole diameter was 2mm.Tita nium condyle prosthesis was divided into two kinds of types ,which were bar and bend titanium condyle prosthesis .Titanium bolt length was 5mm,7mm,9mm,10mm,diameter 1.5mm.The f ixed method was that basing the position of temporo -mandibular joint fossa and the shape of bar titanium condyle prosthesis a groove was made with bone knife on the su rface of the ramus or body of mandible after cutting condyle or ramus of mandible,and then the titanium condyle prosthesis was fixed i n the ramus or body of mandible with th e bolts.The time of intermaxillary fixation was two weeks.Results:10titanium condyle prosthesis were implanted in the patients,which were 4cases with temporo -mandibular joint anklosis,4cases with ameloblastoma and 2cases with keratocyst.The fine effect o f clinical application on artificial bar titanium condyle pro sthesis for reconstruction of temporo -mandibular joint was obtained by observation though 6to 24months.Conclusions:Artificial bar titanium condyle pro sthesis for reconstruction of temporo -mandibular joint has possessed s ome advantages,such as finer biology co mpatibility,simple operation,fix ation stabilization,taking moveme nt of different direction,imme-diately restoration of looks and functions in patient,and fitting for th e clinical application in reconstru ction of temporo -mandibular joint.[